What is OHIP billing code J065?

J065 is "Dilation of non-vascular structures", an OHIP Cardio-Thoracic Surgery code from the Ontario Schedule of Benefits (Physician Services).

How much does J065 pay?

The current OHIP fee for J065 is $36.15, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill J065 to OHIP?

J065 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates J065 claims against the Schedule of Benefits rules before submission.

All codes

J065

J065 – Dilation of non-vascular structures

OHIP Cardio-Thoracic Surgery Code — CLINICAL PROCEDURES ASSOCIATED WITH DIAGNOSTIC RADIOLOGICAL EXAMINATIONS · Schedule of Benefits

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Represents the procedural service for the dilation of non-vascular structures. The fee is for the procedure itself, with separate calculations for anaesthesia and surgical assistance if required. Anaesthesia has 6 base units assigned.

When to Use

Use J065 for the dilation of non-vascular structures, such as esophageal strictures or stenotic ducts, when performed as a clinical procedure associated with diagnostic radiology.
Select this code for procedural interventions that involve mechanical dilation of non-vascular lumens that do not fall under more specific site-based surgical codes.

Common Pitfalls

Do not bill J065 for vascular dilations, as these are governed by separate vascular surgery or interventional radiology codes.
Avoid billing J065 in conjunction with other procedural codes for the same anatomical site if the Schedule of Benefits considers the services bundled or inclusive of the primary procedure.
Failure to include the required referral information from a physician or nurse practitioner will result in claim rejection.

Billing Tips

Ensure you utilize the 6 base units assigned to J065 when calculating anaesthesia fees, and append the appropriate age-based or ASA-status modifiers to maximize the anaesthetic claim.
If surgical assistance is required, you must submit a letter of justification alongside the claim using fee code M400B to secure payment for the assistant.

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Provider Fee$36.15

Anaesthetist Fee$95.76

Non-Anaesthetist Fee$95.76

Effective: April 1, 2026

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